Friday, April 24, 2009

So my techno-reluctant partner finally read my blog, and remarked that I seem very detached. It makes sense that he would think so, since we live together and he has witnessed most of the peaks and nadirs of my emotional reaction to this whole cancer issue. I think that writing allows me to get a bit more scientific about it all, dissect the experience much like that fetal pig in Bio 101 (8 feet of intestines!). But sometimes not. Like that last one. I sat down to write and didn't even know what was coming until it was on the page. Every pathetic bit of it.

Anyway, today I've had enough of cancer, and I'm going to tell you about just a couple of things that have made me very happy lately.

These flowers were given to me at an awesome party that my friends had for me. They fed me treats (tiramisu!) and made me laugh and gave me presents. The next morning, the flowers and our Easter eggs were lit up in the morning sun on the kitchen counter. A bunch of fresh flowers in my kitchen never fails to make me cheerful. The daffodils in our yard are about to open, and a couple dozen tulips that I planted last fall are coming up. Greg built a cage to protect them from the deer, so I'll actually get to see them bloom this year.

I finally got some jewelry finished, and I'll be able to get my etsy shop looking swell before I head off to surgery. I also had some business postcards made, and I really love the way that they came out, so I'm starting to feel like I have an actual fledgling business. This is one of the rings that I made.

This is a quilt that I started last spring. The blocks are stitched and pressed, and now I just have to sew them together. Then the batting, backing and binding. I don't know if I'll be able to finish it before surgery, but even if not, seeing it all laid out like this makes me happy.

Claire and I went for a bike ride/walk on the carriage roads last week. We had an orange and some chocolate beside Hadlock Pond.

I gave the kids my old camera. I was looking through my photo library the other day, and came across a series of shots like these that I didn't know were there. They made me laugh. Silly, crazy kids.

Tomorrow I'll probably be back to morosely mulling over mid-life. In the meantime, we're off to enjoy the spring sunshine. I hope you are able to as well.

Tuesday, April 21, 2009

I felt like a 2 year-old child today. A 2 year-old in the middle of a tantrum. I had two appointments scheduled, one for a CTA scan and the other a pre-operation screening of sorts. The breakdown came early, at Mass General West, in the suburbs of Boston, while waiting for the scan that would make a picture of my abdominal blood vessels for my plastic surgeon.

I don’t know exactly what it was that triggered my emotional roller coaster ride, but I do know it started with feeling grumpy. Really grumpy. Grumpy that Greg and I were sitting in a non-descript waiting room in a non-descript highwayside building on a lovely spring morning. Grumpy that I couldn’t eat any of the sea salt chocolate in my bag. Grumpy that it was taking so long for them to call my name. Grumpy evolved into downright pissed pretty quickly. I was angry. What was I doing here, anyway? I’m a healthy person. I’m not sick. To hell with this.

And then the anger melted into tears, and I was so sad and so tired of waiting and worrying and trying not to worry. I was sad about having cancer, about having to have another IV to inject dye that would make me feel like I really was a 2 year-old, pre-potty training. I was sad about needing surgery and about the stress of working out all the details of taking care of a family and cancer concurrently. But they finally called me in, and it wasn't so bad.

I thought I was over it by the time we got to the second appointment, 3 hours later in downtown Boston. And mostly I was. But we were in a shabbier looking wing of the hospital, and the waiting room was windowless, devoid of magazines and full of people preparing for surgery. No matter how much I believe in my treatment plan, no matter how certain I am that the choices I have made are right for me, it is very difficult to be optimistic while sitting in a crowded room with no natural light or distractions other than fellow patients. There was a young woman beside us in a wheelchair, and she would periodically moan from the depth of her belly, a sorrowful and weary sound. I felt like that. I wanted to make that sound, too. Her caregiver would comfort her, and she would quiet. And then she would begin to cry and her wail was so desperate, I felt as though my own heart were breaking. Which, of course, it was. As it has over and over again these past few months.

These moments, like the tantrum and the deep despair of that second waiting room, they come, but they pass quickly. I’m lucky that the situations that breed them are so few and far between for me. There are many ways in which I am lucky. I know that, and I appreciate it. I have read that some cancer survivors view the disease as a gift of sorts. No one will ever convince me that cancer is a gift. While cancer may be an effective way to get life lessons quickly, I won’t ever be grateful for it. Perhaps for the lessons, of which I can already see the outlines, but not for the cancer.

I had hoped, when I sat to write, that I would pull something insightful or at least a little lighter out of the tangle of feelings that I had today. But I guess not. Maybe next time. Thanks for listening anyway.

Saturday, April 11, 2009

I'm getting really tired of thinking about my breasts. Tired of talking about them, tired of writing about them. Unfortunately, I'm not tired of having them, but that's another story. But I set out to write about this dreadful experience, and though I can gloss over much of it, I have to explain the process behind making the most difficult decision so far. Probably the most difficult decision I've ever made, though I do tend to forget things...

I know that I am lucky to have had a choice at all. Many women don't get to choose whether they will keep a breast or not, whether they have reconstruction at the time of surgery or later, whether they have one sort or another of reconstruction. Just as I am lucky that we caught it early, that I will probably get out of this whole wretched experience with surgery and little else.

The mastectomy on the left was a definite. The prophylactic mastectomy and the reconstruction were up to me. I would say that I have a fairly alternative view regarding health and medical treatment. I had both my babies at home. I've been seeing an osteopath since I was pregnant with Claire, and while he is an M.D., appointments with him don't bear much resemblance to your standard office visit. I treat my migraines myself and have started acupuncture to help me prepare for surgery and to later recover from it. I don't believe that Western medicine always has the answer, and I do believe that sometimes the Western approach is too drastic and invasive. Funny, then, that I should decide to remove what appears to be a perfectly healthy part of my body.

Ah, but there it is. It appears to be perfectly healthy. I now know that I can appear perfectly healthy (I do right now), and actually have this monster of a disease hiding inside. I now know that I have an increased risk of cancer in the apparently healthy breast because of the multifocal nature of the cancer on the left. I now know that I am, in fact, willing to take measures both drastic and invasive for the increased chance at a long life without so large a shadow hovering over me. I am electing to have the prophylactic mastectomy.

And then there is the reconstruction thing. Would it be so bad to be flat-chested? Probably not. But I'm pretty sure that I will be happier with a reasonable facsimile of what I am about to lose. And I'm pretty sure that I'll be happier with all my own skin and fat, albeit relocated a bit. The surgery is going to be long, the recovery is going to be longer, and I have no doubt it will be hard. But six or even eight weeks is a short time in relation to the amount of time I intend to live. You know, another 40 or 50 years or so.

These decisions wrung me out. I was not myself for a number of days while in the midst of making them. But my friends and family helped me sort through all the facts, to reach the best decision for me. In particular I need to thank a college friend who has just come through a similar experience, and Greg, who even got to watch a dvd about breast reconstruction. Thanks, too, to all who listened to me drone on and on about silicone and flaps and risk and scars. Now that I have made the decision, I feel lighter. I'm ready for the reality. I'm scheduled for surgery May 4. Wish me luck. But I'll probably post again before that. And maybe I won't even write about cancer.

Tuesday, April 7, 2009

The logistics of this cancer thing can be overwhelming. After the diagnosis there is research to be done, and doctors to be chosen, and appointments to get to. And sometimes, there are difficult choices to be made.

My diagnosis came after my first mammogram. A mammogram, mind you, that I really didn't believe I needed. With no maternal family history of cancer to speak of, certainly not among my closest relatives, I really didn't think it was an issue. I expected heart problems, diabetes, vascular issues. But not cancer. I went for the mammogram because I turned 40 last July and my doctor told me to. For good or bad, I tend to do what authority figures tell me to do. In this case, if it hasn't saved my life, it has almost certainly saved me a good deal of pain and trauma.

I was diagnosed with multifocal microinvasive ductal carcinoma in situ (DCIS) in my left breast. The microinvasive means that it has just started to move out of the ducts, which is not a good thing, but it could be worse. The multifocal means that it has started in a number of distinct areas, which means that it isn't really feasible to treat it by removing just an area of my breast. The whole thing has to go. If the cancer hasn't reached the lymph nodes, which we will know after surgery, then I won't need radiation or chemotherapy. I'll take an estrogen blocking pill for five years, and hopefully leave this nightmare behind me.

So I got the news about the one breast and promptly made an appointment with Dana Farber Cancer Institute in Boston. My surgeon told me during the first appointment that she and the radiologist at Dana Farber were concerned about an area on my right breast as well. By this time, I had more or less absorbed the news; the new concern threw me into turmoil once more. I did not immediately realize that I could simply elect to have bilateral mastectomies, which is what I am considering now that I know it is an option. Though it seems a bit drastic, I really, really don't want to go through this again. Even now, after I've had a mammogram on my right in Boston and the result was that there is no cause for immediate alarm, I'm not sure I want to wait and see.

So that is one choice that I need to make, and the other is whether to have breast reconstruction. Very interesting to me as I have asked for thoughts from my friends is the difference between the male view and the female view. This is by no means a comprehensive study, or even a study at all, especially since the male views are really just from a handful of fellows. The women have had varied opinions, though tending toward a vote for reconstruction. But without exception, the men have been less equivocal. They are supportive of me whatever I choose, but they believe, as one of them said, that "breasts are overrated." I found this somewhat surprising, and I'm sorry guys, but my breasts are not overrated. At least not to me. Expendable perhaps. But not overrated. I am very fond of them, and will miss one (or both) of them. Enough so that I probably will elect to replace whatever we remove, however inferior to the originals the new ones may prove to be.